Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters

Abstract Intermittent catheterization is the gold standard method for bladder management in individuals with urinary retention and/or incontinence. It is therefore important to understand the performance of urinary catheters, especially on parameters associated to risks of developing urinary tract i...

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Main Authors: Fabio Tentor, Brit Grønholt Schrøder, Simon Nielsen, Lars Schertiger, Kristian Stærk, Thomas Emil Andersen, Per Bagi, Lene Feldskov Nielsen
Format: Article
Language:English
Published: Nature Portfolio 2022-10-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-022-21122-6
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author Fabio Tentor
Brit Grønholt Schrøder
Simon Nielsen
Lars Schertiger
Kristian Stærk
Thomas Emil Andersen
Per Bagi
Lene Feldskov Nielsen
author_facet Fabio Tentor
Brit Grønholt Schrøder
Simon Nielsen
Lars Schertiger
Kristian Stærk
Thomas Emil Andersen
Per Bagi
Lene Feldskov Nielsen
author_sort Fabio Tentor
collection DOAJ
description Abstract Intermittent catheterization is the gold standard method for bladder management in individuals with urinary retention and/or incontinence. It is therefore important to understand the performance of urinary catheters, especially on parameters associated to risks of developing urinary tract infections, and that may impact the quality of life for urinary catheter users. Examples of such parameters include, urine flowrate, occurrence of flow-stops, and residual urine left in the bladder after flow-stop. Reliable in-vitro and/or ex-vivo laboratory models represent a strong asset to assess the performance of urinary catheters, preceding and guiding in-vivo animal studies and/or human clinical studies. Existing laboratory models are generally simplified, covering only portions of the catheterization process, or poorly reflect clinical procedures. In this work, we developed an ex-vivo porcine lower urinary tract model that better reflects the catheterization procedure in humans and allows to investigate the performance of standard of care catheters. The performance of three standard of care catheters was investigated in the developed model showing significant differences in terms of flowrate. No differences were detected in terms of residual volume in the bladder at first flow-stop also when tuning the abdominal pressure to mimic a sitting down and standing up position. A newly discovered phenomenon named hammering was detected and measured. Lastly, mucosal suction was observed and measured in all standard of care catheters, raising the concern for microtrauma during catheterization and a need for new and improved urinary catheter designs. Results obtained with the ex-vivo model were compared to in-vivo studies, highlighting similar concerns.
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spelling doaj.art-a74e483bdf6a456c810e56055700856f2023-04-23T11:13:14ZengNature PortfolioScientific Reports2045-23222022-10-0112111710.1038/s41598-022-21122-6Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary cathetersFabio Tentor0Brit Grønholt Schrøder1Simon Nielsen2Lars Schertiger3Kristian Stærk4Thomas Emil Andersen5Per Bagi6Lene Feldskov Nielsen7Coloplast A/SColoplast A/SColoplast A/SColoplast A/SResearch Unit of Clinical Microbiology, University of Southern DenmarkResearch Unit of Clinical Microbiology, University of Southern DenmarkDepartment of Urology, Centre for Cancer and Organ Diseases, RigshospitaletColoplast A/SAbstract Intermittent catheterization is the gold standard method for bladder management in individuals with urinary retention and/or incontinence. It is therefore important to understand the performance of urinary catheters, especially on parameters associated to risks of developing urinary tract infections, and that may impact the quality of life for urinary catheter users. Examples of such parameters include, urine flowrate, occurrence of flow-stops, and residual urine left in the bladder after flow-stop. Reliable in-vitro and/or ex-vivo laboratory models represent a strong asset to assess the performance of urinary catheters, preceding and guiding in-vivo animal studies and/or human clinical studies. Existing laboratory models are generally simplified, covering only portions of the catheterization process, or poorly reflect clinical procedures. In this work, we developed an ex-vivo porcine lower urinary tract model that better reflects the catheterization procedure in humans and allows to investigate the performance of standard of care catheters. The performance of three standard of care catheters was investigated in the developed model showing significant differences in terms of flowrate. No differences were detected in terms of residual volume in the bladder at first flow-stop also when tuning the abdominal pressure to mimic a sitting down and standing up position. A newly discovered phenomenon named hammering was detected and measured. Lastly, mucosal suction was observed and measured in all standard of care catheters, raising the concern for microtrauma during catheterization and a need for new and improved urinary catheter designs. Results obtained with the ex-vivo model were compared to in-vivo studies, highlighting similar concerns.https://doi.org/10.1038/s41598-022-21122-6
spellingShingle Fabio Tentor
Brit Grønholt Schrøder
Simon Nielsen
Lars Schertiger
Kristian Stærk
Thomas Emil Andersen
Per Bagi
Lene Feldskov Nielsen
Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters
Scientific Reports
title Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters
title_full Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters
title_fullStr Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters
title_full_unstemmed Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters
title_short Development of an ex-vivo porcine lower urinary tract model to evaluate the performance of urinary catheters
title_sort development of an ex vivo porcine lower urinary tract model to evaluate the performance of urinary catheters
url https://doi.org/10.1038/s41598-022-21122-6
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